Coeliac disease
Coeliac Disease (CD) is a chronic life-long inflammatory disease of the small bowel intestinal lining and may even affect as much as 1% of the UK child population according to the British Medical Journal. It is triggered by a delayed allergic reaction to a protein called gluten in the normal diet. Gluten is a protein found mainly in Wheat and to a lesser extent in Rye and Barley. Hence the alternative name for the condition of Gluten-sensitive Enteropathy. People with stable Coeliac Disease will tolerate Oats in the diet.Coeliac Disease (CD) is an inherited disease of the intestinal immune system and affects both men and women. It is highly prevalent in the United Kingdom, affecting 1 in 300 or more people but can be quite difficult to reliably detect. Most CD is finally diagnosed in adulthood usually in the 30-45 year age group. As a result, many cases go undiscovered and are often falsely diagnosed as Irritable Bowel Syndrome (IBS). In fact only about one third of cases are ever diagnosed as CD and appropriately treated with a gluten-free diet. Untreated CD is associated with long-term health risks such as osteoporosis, anaemia and gastrointestinal malignancy.
Samuel Gee first described the condition in 1888. The classical symptoms are malabsorption of food and chronic diarrhoea associated with anaemia, rickets, failure to grow, abdominal bloating, offensive bulky stools, a blistering rash on the buttocks and mouth ulcers. Small children usually become symptomatic when they are weaned off milk onto solids. They present with weight loss, refusal to feed, irritability, abdominal swelling and diarrhoea. However in adults, the disease often presents in an atypical form and may be missed – especially with non-specific symptoms such as fatigue, mouth ulcers, skin rashes, vague abdominal pains, intermittent diarrhoea and chronic anaemia.
A rash called Dermatitis Herpetiformis may occur rarely in Coeliac Disease. It is an intensely itchy rash with symmetrical fine blisters which typically appear on the back, elbows or scalp, almost all people with Dermatitis Herpetiformis have Coeliac Disease.
Certain groups of people are at greater risk for developing Coeliac Disease. It is commoner in individuals from families that already have the condition (being linked to the HLA DQ3 gene). Coeliac Disease is more likely to occur in people with Diabetes on Insulin, Downs Syndrome, Sarcoidosis, Infertility, IgA antibody deficiency and certain autoimmune diseases such as Thyroid disease, Rheumatoid Arthritis, Chronic active Hepatitis, Addisons disease and Sjorgens syndrome of dry eyes and mouth.
